Sr. Director, Revenue Cycle
3 weeks ago
This position is located at our Lloyd Corporate Plaza building in NE Portland, Kerns area. The schedule for this position is Monday through Friday, business hours.
Job Overview
The Sr. Director, Revenue Cycle's responsibilities are managing the operations of the billing department. Key focus areas are planning and directing patient insurance documentation, coding, billing, and data processing to ensure accurate billing and efficient account collection. Additional areas of responsibility include credentialing and payer contract management. Duties also include leadership and oversight of the revenue cycle workforce. Ultimately, a top-performing Sr. Director, Revenue Cycle should seek ways to improve the functioning of the Revenue Cycle Department.
This position must understand, appreciate, and respect the diversity and cultural differences within our Cascadia community. As such, it is expected that this position promotes integrated care, our vision of trauma-informed and person-first approaches and helps create a work environment of inclusion, safety, and acceptance.
Essential Duties
This position description is not intended to be an all-inclusive list of responsibilities, skills, or working conditions associated with the position. Management reserves the right to modify, add or remove duties as necessary.
* Lead the Revenue Cycle Department* Optimize the structure of department's workflow and staffing.* Responsible for account management, communications with insurance providers, collections, cash posting, contract analysis, and billing.* Efficiently manage patient complaints in respect of billing and collections.* Review and approve financial or medical hardship discounts / write-offs.* Develop policies and procedures across the department
* Ensure Effective Accounts Receivables (A/R) Performance* Ensure claims are submitted quickly, accurately and in a timely manner.* Ensure patients understand statements and pay outstanding balances.* Monitor A/R performance and monitor aging or uncollected balances.* Audit current procedures to monitor and improve efficiency of billing operations.* Oversee the coding and denial management processes
* Contract Management** Oversee the negotiation, creation, and management of contracts within the healthcare industry.* Ensure compliance with laws and regulations governing healthcare contracts.* Review and analyze contract terms and conditions.* Collaborate with internal departments to ensure contract terms meet organizational needs.* Monitor contract performance and compliance.* Keep abreast of changes in the healthcare industry that may impact on contracts.
* Credentialing Oversight* Ensure compliance with regulatory and accreditation standards related to provider credentialing.* Collaborate with internal departments, such as People and Culture, to ensure provider credentialing requirements are met.
* Manage staff performance* Provide regular feedback, performance reviews, and one-on-one meetings.* Oversee the hiring and training of staff.
* Ensure Compliance to Applicable Rules and Regulations* Routinely monitor billing compliance by reviewing documentation, coding, and billing. This includes working with Information Technology (IT) and the providers to improve accurate charge capture when CID-10-CM and CPT/HCPCS codes are updated.* Work with the organization's HIPAA Privacy/Security Officer to ensure new hire and annual training is conducted with your entire department workforce.
* Perform other job-related duties as assigned
Qualifications
Education:
Bachelor's degree in finance, Business Administration, Healthcare Administration, or related field and certification in revenue cycle management specifically.
Experience:
Ten (10) years healthcare revenue cycle experience.
Proven leadership and customer service skills are also required for this position.
Experience with EPIC Electronic Health Record (EHR) system preferred.
Specialized Knowledge, Skills, and Abilities:
* Sound knowledge of health insurance programs and contracts* Possess in-depth knowledge and understanding of Medicare, Medicaid, and Managed Care regulations.* Proficiency in Excel including but not limited to Pivot Tables and Lookup functions* Ability to adapt to changing technology* Ability to read, interpret, research, explain and apply laws, rules, regulations, policies, and procedures related to program business* Ability to prepare complex reports
Core Competencies
Leadership and Decision Making:
Make decisions with little guidance and review
Maintain confidentiality of information as appropriate
Interpersonal:
Excellent verbal and written communication skills
Effectively engage with internal providers, external providers, and stakeholders
Work independently as well as part of a team
Demonstrate a work history of dependability
Contribute to cost savings by identifying opportunities to improve methods, systems, and procedures to increase productivity and enhance services
Understand, appreciate, and respect diversity and cultural differences.
Working Conditions
Work is performed in an office environment at Cascadia's Administrative building. Work is performed Monday Friday during typical business hours. Occasional weekends and/or evenings hours may be necessary.
Mental Demands:
This position will have a varied routine which requires the ability to manage a variety of tasks as well as various deadlines and requirements, in addition to having recurring monthly responsibilities
Physical Demands:
A typical workday consists of sitting at a desk and utilizing computers and other office equipment.
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